A randomized controlled trial of very early rehabilitation in speech after stroke

“Aphasia affects approximately a third of the 440,000 individuals living with stroke in Australia. Recovery from aphasia is highly variable with multiple factors believed to contribute to the overall extent of communication recovery achieved by each individual. There are currently few available specific medical treatments designed to reduce the impacts of aphasia occurring as a consequence of stroke; therefore, aphasia rehabilitation is the mainstay of recovery for people with aphasia.

Early aphasia rehabilitation is thought to enhance the natural processes of spontaneous recovery by strengthening neural networks through the use of highly repetitious, task-specific behaviors that require coinciding neuronal firing of a group of connected neurons. These behaviors are believed to minimize independent neuronal activation that may produce maladaptive behaviours.

The 2012 Cochrane Review examined 39 trials of aphasia therapy following stroke and found no Level 1 evidence for the efficacy of aphasia treatments in the long term. There was some evidence that speech and language therapy (SLT) was more effective than no SLT; however, caution is required when interpreting the Cochrane Review results as many studies were comparative in nature, lacked adherence to the CONSORT statement and demonstrated inferior design quality. Additionally, little is known about the costs of available treatment options.”

A research team carried out a research with the Very Early Rehabilitation of Speech (VERSE) trial to “aim to determine if intensive prescribed aphasia therapy (VERSE) is more effective and cost saving than non-prescribed, intensive (usual care-plus) and nonintensive usual care (UC) therapy when started within 15 days of stroke onset and continued daily over four weeks. We hypothesize that aphasia therapy when started very early after stroke and delivered daily could enhance recovery of communication compared with UC.”

More details of the research can be found at:

https://journals.sagepub.com/doi/abs/10.1177/1747493016641116

https://www.ecu.edu.au/__data/assets/pdf_file/0004/728887/2016_Godecke-et-al_VERSE-protocol_IJS.pdf